By Andy Lauder and George Coxon, members of the Unite/Mental Health Nurses Association Organising Professional Committee
Yesterday the Health Select Committee published its report on its post-legislative scrutiny of the Mental Health Act 2007. Andy Lauder and George Coxon (members of the Unite/Mental Health Nurses Association Organising Professional Committee) put forward a few thoughts.
Mental health has been for many years one of the top five priorities for this and previous governments. All political parties have said how important this area of healthcare is to get right and yet they continue to fail to address key themes and needs of people with mental health problems.
Despite Government and the Department of Health placing high importance on the provision of mental health care, Clinical Commissioning Groups and predecessor commissioning organisations have failed to translate this into real funding commitments for mental health services.
Resourcing adequate care for the most vulnerable members of our communities remains a major concern. People being sectioned under the mental health act admitted to hospital are a strong example of where services and systems are struggling. The complexity of needing different professionals involved in this process providing robust collaborative involvement often causes significant risk and difficulty.
At best NHS funding calculations show that mental health care accounts for a mere 14% of the overall health care spend yet most accept that the health burden in terms of overall impact on everyday life for people is considerably greater.
The MHNA and MHNs have a duty of care to raise and seek to address concerns about unsafe and inadequate practice and where necessary ensure that action is taken to protect service users and those involved in delivering services.
Often regarded as a Cinderella service of the NHS, mental health services are usually the first to feel any cuts in funding. In many areas around the country funding has been cut back so much that over 50% of inpatients beds have been closed in recent years. With fewer inpatient beds it becomes more difficult to admit people needing the level of care and treatment only able to be offered in a hospital environment. This leads to people being treated in the community inappropriately and individual’s conditions deteriorating unnecessarily. People, nowadays, have to be considerably more unwell and in more severe states of distress, neglect and disturbance than in previous years before being considered suitable for admission to hospitals and beds are at such a premium most wards have beds occupied by those detained under the Mental Health Act 2008.
The current activity profile and pattern of care affecting people needing appropriate mental health care support needs to stop. More inpatient beds need to made available for people that need; intensive 24/7 assessment; managed care including crisis support; respite and intensive treatment; and containment only available with well-resourced holistic care provided in dedicated ‘fit for purpose’ hospitals. However it is also true that more also needs to be done to ensure that community teams have enough staff – where currently many teams are working over capacity and have large waiting lists. More needs to be done to provide access to ‘talking therapies’ to ensure that people are treated as soon as possible to avoid any deterioration in their conditions putting more pressure on already stretched services.
This and many other issues will be discussed at the upcoming Unite in Health policy session on the integration of mental health services. If you’re a member why not join us?